Pneumomediastinum Esophograms

This is Todd Ponsky doing another review for the Journal of Pediatric Surgery. Today, we're gonna review our esophagrams indicated in pediatric patients with spontaneous pneumo mediastinum. The first author is Doctor Edward Richer, and the second author is Ramon Sanchez from CS Mott Children's Hospital, University of Michigan. This study addresses that common problem of when kids come in with either spontaneous or traumatic pneumo mediastinum trying to figure out how much workup we have to do. Do they need additional studies such as esophagrams or CT scans. So they did a 16 year retrospective review looking at all patients that had an esophagram for the diagnosis of pneumo mediastinum. And what they found is in the patients with spontaneous pneumo mediastinum, the esophagrams never showed anything. Of all the patients, there was no leak or no injury shown in the esophagram. 55% of these patients also had a CAT scan, and none of the CAT scans came back with any positive findings. Also, all the additional X-rays that were done to find out more about the pneumo mediastinum, none of them helped either. Then they looked at traumatic pneumo mediastinum, and they found that again, the esophagram never showed any findings. It did not help. It did not show a leak or a rupture in patients that looked clinically well. They did not mention anything about CAT scan. They did say that the, the CAT scans were done, but they did not mention the results. And then they also didn't mention anything about additional X-rays in this group. So overall, it looks like in patients that are looking clinically well with spontaneous pneumo mediastinum or traumatic pneumo mediastinum, there's really no benefit or need to getting additional studies such as esophagrams or CT scans. I want to thank Ian Glenn for helping review this article and editing the video. Uh, please leave comments or questions below and let us know, uh, any other studies you'd like us to review. Thanks.